In the absence of meaning: care practices and environmental factors behind the multiple selves of the digital psychiatry participant.

This paper compares formal accounts that laboratory members use to describe a digital psychiatry intervention with lab practices as they were observed ethnographically. The intervention uses correlations between wearable data and self-reports of mood to produce behavior change recommendations, which participants then implement with the help of a guide. In formal accounts, the trial is described as the accomplishment of the individual participant who is empowered by data-driven insights. Formal accounts from the lab present this participant as multi-layered. In observation, however, participants do not seem multiple. Instead, the contingencies of living and working environments come to the fore. Observations of open-ended interactions in guidance sessions, which are minimized in formal accounts, are particularly powerful in capturing these contingencies. The critique of representation from philosophical pragmatism shows how the multi-layered participant is similar to the multiple representational meanings entities take on according to theories common in twentieth-century psychiatry, and supports the ethnographic approach as a way out of these paradoxical formulations. The paper, thus, explains the role of otherwise underspecified human labor involved in the trial, while demonstrating ethnography's ability to account for interactions with participants, through which we gain insights into the contingent, emplaced process of implementing the trial. [ABSTRACT FROM AUTHOR]